远外侧经枕髁入路显微切除延颈髓腹侧肿瘤的手术探讨

目的:探讨远外侧经髁入路显微切除延颈髓交界区腹侧肿瘤的手术方法。方法:自2003年3月至2006年4月应用远外侧经髁入路显微切除延颈髓腹侧及腹外侧肿瘤3例,其中脊膜瘤1例,神经纤维瘤1例,神经鞘瘤恶性变1例。结果:2例肿瘤全切除,1例硬膜下肿瘤全切除,硬膜外肿瘤部分切除。无手术死亡,但有1例存在后组颅神经损伤症状。结论:该手术入路可增加术野空间,从而更大程度上显露肿瘤组织,有利于减少对脑干和重要血管神经的牵拉。

Removing ventral or ventral-lateral tumors around craniocervical junction region by the far-lateral transcondylar approach

Objective:To explore a surgical approach for removing ventral or ventral-lateral tumours around craniocervical junction region by far-lateral transcondylar management.Methods:Three patients with ventral and ventral-lateral tumors were performed operation through the far-lateral transcondylar approach from March 2003 to April 2006.Cases of 1 chordoma,1 neurofibroma and 1 malignant nerve sheath tumour were included for this study.Results:Among the 3 patients,2 cases achieved total removal of the tumor and 1,subtotal removal.No surgical mortality occurred in this series,but there was one case complicated with lower cranial nerve deficit.Conclusion:This approach can provide exposure of larger operative site for making less involvement of the brain stem or cranial blood vessels and nerves.